Individual
DR. JUSTIN KIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1971 MCCULLOCH BLVD N, SUITE 100, LAKE HAVASU CITY, AZ 86403-5748
(928) 733-6070
Mailing address
1971 MCCULLOCH BLVD N STE 100, LAKE HAVASU CITY, AZ 86403-5748
(928) 733-6070
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009296
AZ
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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